Diabetes mellitus (DM) is a condition of uncontrolled diabetes. The market for diabetes treatment has grown by a compound …
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Diabetes: Fact Sheet
Insulin is a pancreatic peptidic hormone that regulates sugar metabolism Diabetes mellitus DM is a chronic disease that occurs when the pancreas does not produce enough insulin, or alternatively, when the body cannot effectively use the insulin it produces Hyperglycemia, or raised blood sugar, is a common condition of uncontrolled diabetes Over time, it leads to serious damage to many of the bodys systems, especially the nerves and blood vessels The market for diabetes treatment has grown by a compound average rate of almost 20 over the last decade, from almost 4 billion in 1995 to more than 17 billion in 20051 Overall, anti-diabetic drug sales are expected to increase to 22 billion by 2012 as the addressable patient population continues to increase1 The World Health Organization estimates that more than 180 million people worldwide have diabetes and this number is likely to more than double to approximately 370 million by 20302 Type 1 diabetes, previously known as juvenile-onset diabetes or insulin-dependent diabetes, is characterized by a lack of insulin production Without daily administration of insulin, Type 1 diabetes is rapidly fatal
Type 2 diabetes, previously known as adult-onset diabetes or non-insulin dependent diabetes, results from the bodys ineffective use of insulin Type 2 diabetes comprises 90 of people with DM around the world, and is largely the result of excess body weight and physical inactivity A third type of diabetes, gestational diabetes mellitus GDM, develops during some cases of pregnancy but usually disappears after pregnancy People with Type 1 diabetes require daily injections of insulin to survive People with Type 2 diabetes can sometimes manage their condition with lifestyle measures alone However, oral drugs are often required, and sometimes insulin, in order to achieve good metabolic control A number of drug therapies are available for treating diabetes They are given either alone or as combinations with or without insulin injections These medications generally fall into the categories of:
Drug Class Sulfonylureas Meglitinides Biguanides Thiazolidinediones Alpha-glucosidase inhibitors Dipeptidylpeptidase-4 DPP-4 inhibitors
Mode of Action Stimulating beta cells to increase insulin production Also known as postprandial glucose PPG regulators, these compounds act by stimulating insulin
secretion from the pancreas Inhibiting hepatic glucose production and increasing the sensitivity of peripheral tissues to insulin Increasing peripheral glucose utilization in skeletal muscle and adipose tissue, reducing hepatic glucose output, increasing fatty acid uptake and reducing lipolysis in adipose cells Slowing enzymatic degradation of complex carbohydrates and hence reducing absorption of glucose Blocking an enzyme called DPP4 which breaks down peptides that boost the release of insulin after blood sugar rises, such as after a meal 1
Examples glipizide, glyburide nateglinide, repaglinide metformin pioglitazone, rosiglitazone acarbose, miglitol saxagliptin, sitagliptin
Existing therapies have also been associated with various drawbacks and side effects such as weight gain, GI side effects, increased risk of hypoglycemia, liver toxicity and high cost
Hydroxysteroid Dehydrogenase Inhibitors
Glucocorticoids are hormones found naturally in the body that help regulate carbohydrate, fat, and protein metabolism The primary glucocorticoid in man, cortisol, opposes the secretion and action of insulin in multiple tissue types and is thought to play a central role in the
development and progression of diabetes The 11-hydroxysteroid dehydrogenase type 1 11-HSD1 enzyme regulates glucocorticoid activity and catalyzes the conversion of inactive cortisone to active cortisol in active target tissues Therefore, inhibition of 11-HSD1 activity offers the potential of a novel therapeutic for diabetes and obesity by restoring the glucose-lowering action of insulin
blood pressure insulin resistance insulin production
glucose cortisol cytosol
fat cells
cortisone
ER lumen anti-diabetic drug 11-HSD1
References
1 2
RD Directions, Volume 12, Number 9, Page 52, October 2006 World Health Organization Fact Sheet No 312, September 2006 2
Source:vitaepharma.com
